Teenage Baseball Pitchers At Risk For Permanent Shoulder Injury

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A very interesting story from PRWeb about over-pitching teens in baseball. What are your thoughts about this article? Please share in the comments section…..

newsYoung baseball pitchers who throw more than 100 pitches per week are at risk for a newly identified overuse injury that can impede normal shoulder development and lead to additional problems, including rotator cuff tears, according to a new study published online in the journal Radiology.

The injury, termed acromial apophysiolysis by the researchers, is characterized by incomplete fusion and tenderness at the acromion. The acromion, which forms the bone at the top or roof of the shoulder, typically develops from four individual bones into one bone during the teenage years.

“We kept seeing this injury over and over again in young athletes who come to the hospital at the end of the baseball season with shoulder pain and edema at the acromion on MRI, but no other imaging findings,” said Johannes B. Roedl, M.D., a radiologist in the musculoskeletal division at Thomas Jefferson University Hospital in Philadelphia.

To investigate the unexplained pain, Dr. Roedl and a team of researchers conducted a retrospective study of 2,372 consecutive patients between the ages of 15 and 25 who underwent magnetic resonance imaging (MRI) for shoulder pain between 1998 and 2012. The majority of the patients, which included both males and females, were baseball pitchers.

“Among high school athletes, pitching is the most common reason for shoulder pain,” Dr. Roedl said.

Sixty-one of the patients, (2.6 percent) had pain at the top of the shoulder and an incomplete fusion of the acromion but no other findings. The patients were then age and sex-matched to patients who did not have the condition to form a control group.

Pitching history was available for 106 of the 122 patients included in the study. Through statistical analysis, the researchers found that throwing more than 100 pitches per week was a substantial risk factor for developing acromial apophysiolysis. Among the patients with this overuse injury, 40 percent threw more than 100 pitches per week, compared to 8 percent in the control group.

“We believe that as a result of overuse, edema develops and the acromion bone does not fuse normally,” Dr. Roedl explained.

All 61 injured patients took a three-month rest from pitching. One patient underwent surgery while the remaining 60 patients were treated conservatively with non-steroidal pain medication.

Follow-up MRI or X-ray imaging studies conducted a minimum of two years later after the patients turned 25 were available for 29 of the 61 injured patients and for 23 of the 61 controls. Follow-up imaging revealed that 25 of the 29 patients (86 percent) with the overuse injury showed incomplete fusion of the acromion, compared to only 1 of the 23 (4 percent) controls.

“The occurrence of acromial apophysiolysis before the age of 25 was a significant risk factor for bone fusion failure at the acromion and rotator cuff tears after age 25,” Dr. Roedl said.

Twenty-one of the 29 patients with the overuse injury continued pitching after the rest period, and all 21 showed incomplete bone fusion at the acromion. Rotator cuff tears were also significantly more common among this group than in the control group (68 percent versus 29 percent, respectively). The severity of the rotator cuff tears was also significantly higher in the overuse injury group compared to the control group.

“This overuse injury can lead to potentially long-term, irreversible consequences including rotator cuff tears later in life,” Dr. Roedl said.

Dr. Roedl and his colleagues suggest teenage and young adult pitchers limit the number of pitches thrown in a week to 100. The American Sports Medicine Institute currently recommends that baseball pitchers between 15 and 18 years of age play no more than two games per week with 50 pitches per game.

“Pitching places incredible stress on the shoulder,” Dr. Roedl said. “It’s important to keep training in the moderate range and not to overdo it.”

Dr. Roedl pointed out that many successful professional baseball pitchers played various positions, and even other sports, as young athletes and thereby avoided overuse shoulder injuries.

“More and more kids are entering sports earlier in life and are overtraining,” he said. “Baseball players who pitch too much are at risk of developing a stress response and overuse injury to the acromion. It is important to limit stress to the growing bones to allow them to develop normally.”

“Acromial Apophysiolysis: Superior Shoulder Pain and Acromial Nonfusion in the Young Throwing Athlete.” Collaborating with Dr. Roedl were William B. Morrison, M.D., Michael G. Ciccotti, M.D., and Adam C. Zoga, M.D. Radiology is edited by Herbert Y. Kressel, M.D., Harvard Medical School, Boston, Mass., and owned and published by the Radiological Society of North America, Inc. (http://radiology.rsna.org/) RSNA is an association of more than 53,000 radiologists, radiation oncologists, medical physicists and related scientists promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Ill. (RSNA.org)

Three Serious Issues Your Shoulder Pain Could Be Hinting At

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By Dr. Louis Catalano

grandparentsEveryone has shoulder pain at some point in their life. Most often, it is caused by rotator cuff tendonitis or shoulder bursitis – maladies that cause pain with activities such as raising the arm overhead, reaching into a coat sleeve, or reaching into the backseat of a car. Often times these pains are sporadic, but not severe.

However, here are three serious issues that your pain could be hinting at:

1. Frozen shoulder or adhesive capsulitis.
This disorder can occur with mild trauma or no injury at all. It is more common in diabetics. Patients present with gradually worsening pain and loss of shoulder range of motion. The range of motion that is often lost is external rotation, or the ability to twist one’s shoulder away from the body with the shoulder at the side and the elbow at a 90-degree angle. The patient can also gradually loose the ability to reach overhead or behind one’s back. This problem should not be ignored because early treatment, including physical therapy and a steroid (cortisone) injection, can make recovery more easy and rapid. By avoiding treatment, the shoulder can become more “frozen”, and make a full recovery of range of motion difficult, if not impossible. Also, surgery may be needed if the shoulder becomes “too frozen”.

2. A pinched nerve in the neck.
These patients present with pain in the back of the shoulder, neck or both. They will also complain of numbness and tingling down the arm and into the hand. Constant numbness/tingling is worrisome. Any weakness of the shoulder, elbow, or hand is very concerning as well. The important point is that any symptoms in the arm/elbow/hand, whether numbness or tingling or weakness, must be evaluated immediately. A pinched nerve in the neck can possibly result in permanent numbness/tingling or weakness, so medical attention should be sought promptly.

3. Cancer.
Pain from a cancer lesion around the shoulder will be severe, constant, and tends to be worse at night. The pain will worsen, and never “go away”. Most patients will be ill, with unexplained weight loss or fevers/chills. I have seen a few patients who sustained a shoulder fracture caused by cancer, and this was the first manifestation of the cancer! Some cancer, like multiple myeloma, develops in bone. Other cancers often metastasize to bone and these include lung, prostate, colon, thyroid, and breast cancers. If a patient has a history of one of these cancers, and has severe, unrelenting shoulder pain, that patient should seek immediate medical attention.

Not all shoulder pain could lead to these, but if you have a decreased range of motion, frequent back pain or any of the above listed symptoms, it might be worth giving your doctor a call.

Louis W. Catalano III, M.D. is an assistant clinical professor of orthopedic surgery at Icahn Mt. Sinai School of Medicine, residency director and attending surgeon in the Department of Orthopedic Surgery at St. Luke’s-Roosevelt Hospital and attending hand surgeon at the CV Starr Hand Surgery Center at Roosevelt Hospital. Dr. Catalano has had his publications appear in the Journal of the American Academy of Orthopedic Surgeons, Hand Clinics, Journal of Hand Surgery and other leading surgical publications. He is presently on NY Magazine’s “Best Doctors List” and takes care of many musicians, dancers and athletes in the New York area. Dr. Catalano currently resides in Pelham Manor with his wife and two children.

La Peer Surgeons Comment On Mark Sanchez’s Potentially Season-Ending Shoulder Injury

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footballSurgeons at the Shoulder Surgery Center of Excellence in Beverly Hills explain New York Jets Quarterback Mark Sanchez’s shoulder injury and discuss his chances of recovery.

A recent article published on ESPN.com has stated that Mark Sanchez is seeking a second opinion on his pre-season shoulder injury. The questions right now are whether or not he has a torn labrum and whether or not he will need surgery to repair it.

“A labral tear can be a deeply troubling injury for any athlete, let alone an NFL quarterback,” said Dr. Eric Millstein, Medical Director at the Shoulder Surgery Center of Excellence. “Even a small tear in the shoulder cartilage can have a huge impact on mobility, strength, and overall performance of the shoulder.”

The labrum is a thick cuff of cartilage in the shoulder where the arm bone, or humerus, meets the body. This cartilage helps keep the ball of the arm secure in the socket. When the labrum is torn, the ball of the shoulder is liable to slide around and potentially become dislocated. This is an especially difficult injury for an NFL quarterback who not only puts very high strain on his arm to throw the ball but is also at risk for impact from the opposing team. This type of injury can be gradual or acute. If the injury is mild, it can often heal on its own with rest and physical therapy. However, in more severe cases, a labral tear may require surgery.

“The surgery for a torn labrum requires us to go into the shoulder and remove the irritated tissue before securing the torn cartilage to the rim of the shoulder socket,” says Dr. Millstein. “We do this as an outpatient procedure so patients can go home the same day.”

In addition to cartilage tears, the Shoulder Surgery Center of Excellence treats a broad range of shoulder injuries, including AC joint separation, degenerative joint disease, rotator cuff tears, shoulder decompression, and more. All of these procedures are performed arthroscopically.

“By performing these surgeries arthroscopically, we’re able to drastically reduce pain for the patient and speed up recovery time,” says Dr. Millstein.

In addition to acting as Medical Director of the Shoulder Surgery Center of Excellence, Dr. Millstein is a member of the Academy of Orthopaedic Surgeons, the American Orthopaedic Society for Sports Medicine, and the Arthroscopy Association of North America. He is also board certified by the American Board of Orthopaedic Surgery.

La Peer Health Systems is an outpatient surgery center in Beverly Hills, founded by doctors and focused on providing excellent patient care alongside the most cutting-edge medical treatments available. With 50 world-renowned physicians in 14 specialties, comprehensive medical treatment is offered that takes patients from consultation to diagnosis, treatment, surgery, and ultimately aftercare. The 14 medical departments include orthopedics & sports medicine, gastroenterology, head & neck surgery, colorectal & general surgery, podiatry, ophthalmology, pain management, plastics & reconstructive surgery, gynecology, spine surgery, interventional cardiology, bariatric surgery, thoracic surgery, and anesthesiology. Unlike large hospitals, La Peer’s unique structure offers extremely personal care in a safe and controlled environment.

To learn more about La Peer Health Systems, visit http://www.lapeerhealth.com.

– Courtesy of PRWeb